Which laser treatment would be best for the deepened lines around mouth and jowls? (Photo)

Question

Hi! I'm 44, not quite ready for a facelift. I've been considering Thermage, Fraxel and Morpheus as lasers to soften the lines around my mouth, loss of volume and jowls. Would any of these help lessen the appearance?? I've done Sculptra and Morpheus once last year. I'm open to any treatment but I feel like doctors I've consulted are pushing what they offer, and I really want to do what's best for my situation. Would love to hear any recommendations or treatment suggestions. Thank you!! MC

Anna Chacon, MD, FAAD · Answer

Thank you for your question and for providing some background on your previous treatments. It's great that you're exploring various options to address the deepened lines around your mouth, loss of volume, and jowls. Here’s an overview of the treatments you mentioned and some additional insights:

Thermage
Indication: Thermage uses radiofrequency energy to stimulate collagen production and tighten the skin.
Effectiveness: It can be effective for mild to moderate skin laxity and early signs of jowls, and it may help soften lines around the mouth.
Consideration: Results can vary, and maintenance treatments are often needed. It's a non-invasive option with minimal downtime.
Fraxel
Indication: Fraxel is a fractional laser that targets aging and sun damage by promoting the skin’s natural healing process.
Effectiveness: It can improve skin texture, reduce fine lines, and enhance skin tone. It’s particularly effective for surface-level imperfections.
Consideration: There is some downtime, typically involving redness and peeling for a few days post-treatment.
Morpheus8
Indication: Morpheus8 combines microneedling with radiofrequency energy to target deeper layers of the skin, promoting collagen and elastin production.
Effectiveness: It can improve skin texture, tighten the skin, and reduce the appearance of fine lines and mild jowls.
Consideration: Multiple sessions are often recommended for optimal results. Since you had this treatment once last year, additional sessions may further enhance your results.
Sculptra
Indication: Sculptra is a dermal filler that stimulates collagen production, providing gradual and natural-looking volume restoration.
Effectiveness: It is beneficial for addressing volume loss and enhancing facial contours over time.
Consideration: Results develop gradually over several months, and multiple sessions are usually required.
Additional Recommendations
Combination Approach: Often, combining treatments yields the best results. For example:

Thermage or Morpheus8 for skin tightening.
Fraxel for improving skin texture and reducing fine lines.
Sculptra or other fillers for volume loss.
Consult with a Board-Certified Dermatologist or Plastic Surgeon: Seek a practitioner who listens to your concerns and offers a range of treatments. Someone with extensive experience in facial rejuvenation can tailor a treatment plan specific to your needs.

Topical Treatments:

Retinol: Encourages cell turnover and can improve skin texture and fine lines.
Vitamin C Serum: Acts as an antioxidant, brightens the skin, and improves collagen production.
Maintenance and Lifestyle: Regular maintenance treatments, a healthy lifestyle, and proper skincare can prolong the effects of these procedures.

Conclusion
Each of these treatments has its own benefits and considerations. A personalized consultation with a reputable and experienced provider will help tailor a treatment plan that best suits your needs and aesthetic goals.

I hope this information helps you make an informed decision. Best of luck on your journey to rejuvenation!

Best regards,

Raffy Karamanoukian, MD, FACS · Answer

Morpheus 8 is a non-invasive skin and soft tissue tightening treatment that is consistently amazing in our patients. We use the Morpheus to exact fractional induced RF into the skin or tissue in order to tighten collagen and stimulate contraction of the tissue. For acne scars, it is quite useful to build collagen in patients who have atrophic scars but is not very productive for ice-pick scars which require TCA Cross. For tissue tightening, Morpheus is ideal for the face and neck and we often combine it with CO2 laser or Ultherapy to further enhance results. Chemical peels and skin resurfacing should be done at least 5 to 7 days after, but can be performed earlier, depending on treatment severity. Avoid exfoliating skin treatments before Morpheus and expect a period of 2-4 weeks for skin contraction to set in.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best, 
Dr. Karamanoukian 
Realself100 Surgeon

A. David Rahimi, MD · Answer

Dear patient, I have all the modalities you describe in your question. Non-surgical lifts with THERMAGE FLX and Ultherapy lift the skin but do not do much for the deep wrinkles around the lips. Micro needling with Radiofrequency (Venus Viva) and aggressive and deel CO2 laser resurfacing are more appropriate for deep wrinkles around the mouth.
I hope you have an aopprtunity to watch our videos.
Dr David R.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your questions and posting your photos. It appears that you would benefit most with fillers and erbium laser resurfacing around your mouth. The deeper folds would improve with the fillers and the lines would improve with the laser. 
See and experienced oculofacial surgeon for comprehensive evaluation and discussion of treatment options. 
Good luck,

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin in Winnetka and Chicago. This is a great question. For addressing deepened lines around the mouth and jowls, CO2 laser resurfacing is often considered the most effective treatment. This laser targets the deeper layers of the skin to stimulate collagen production and promote significant skin tightening and rejuvenation. By removing damaged outer layers and encouraging the formation of new, healthy skin, CO2 lasers can effectively reduce the appearance of deep lines and sagging in the lower face. Another valuable option is Erbium YAG laser, which also focuses on resurfacing but is generally less aggressive than CO2 lasers, making it suitable for those with more sensitive skin or those seeking a gentler approach. Both treatments can lead to substantial improvements in skin texture and firmness, though CO2 lasers typically provide more dramatic results but with a longer recovery period. I hope this helps and best of luck!

Darryl J. Blinski, MD · Answer

Based on your post of photos, you are indeed ready for a mini facelift versus these noninvasive temporary options that will only last very short time versus a surgical intervention. Best virtual consult with. Mini face necklace start from $5000-$10,000.

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